The analysis in 35 female patients of ischemia change in electrocardialgram with normal myocardial perfusion imaging in adenosine stress test

Objective:Investigating the clinical value with myocardial perfusion imaging(MPI) and computed tomography coronary artery(CTCA) in diagnosing coronary artery disease(CAD) of female patients with normal MPI but ischemia change in electrocardiogram(ECG) during adenosine stress test.Methods:Analyzing 4 142 female patients data retrospectively with adenosine stress/rest MPI imaging from May.2008 to November.2011 because of suspecting CAD including 35 female patients age from 39 to 76,mean age 55.74±9.43 with ischemia change in ECG during adenosine stress test but normal in MPI.35 female patients underwent MPI/CTCA by single photon emission computed tomography/integrated computer tomography including 1 petients underwent coronary artery angiography(CAG)in one month.Results:The ECG with 35 female patients were normal at rest while the ST segment horizontally or inclined moved down ≥0.1 mV at adenosine stress test which was showing myocardial ischemia change,and recovering to narmal in ECG after 1 min and the subsequent MPI were narmal.The integrated CTCA showed:among 35 petients,normal coronary arteries in 27 patients(27/35,77.1%),sclerosing change in 7 ones(7/35,20.0%),1 patient(2.9%) was three-vessel disease with all the vessel stenosis≥50%,with CAG showing:proximal LAD stenosis 75%,middle LCX 90% and proximal and middle RCA 95%.The result indicated that 97.1% of the coronary arteries were normal or sclerosing with no ischemia in MIP in this group patients.Conclusion:Female paients are easier to get false positive results in diagnosing CAD in stress ECG,and MPI is a significant method to evaluate these patients whether they have CAD.Integrated CTCA is an important method to avoid false negative due to three-vessel coronary disease in MPI.So it is accurate and noninvasive evaluation method to screen CAD with MPI combined with integrated CTCA for these patients.